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Improvement in Left Ventricular Ejection Fraction in Outpatients With Heart Failure With Reduced Ejection Fraction: Data From CHAMP-HF.

Publication ,  Journal Article
DeVore, AD; Hellkamp, AS; Thomas, L; Albert, NM; Butler, J; Patterson, JH; Spertus, JA; Williams, FB; Duffy, CI; Hernandez, AF; Fonarow, GC
Published in: Circ Heart Fail
July 2020

BACKGROUND: Among patients with heart failure (HF) with reduced ejection fraction (EF), improvements in left ventricular EF (LVEF) are associated with better outcomes and remain an important treatment goal. Patient factors associated with LVEF improvement in routine clinical practice have not been clearly defined. METHODS: CHAMP-HF (Change the Management of Patients with Heart Failure) is a prospective registry of outpatients with HF with reduced EF. Assessments of LVEF are recorded when performed for routine care. We analyzed patients with both baseline and ≥1 follow-up LVEF assessments to describe factors associated with LVEF improvement. RESULTS: In CHAMP-HF, 2623 patients had a baseline and follow-up LVEF assessment. The median age was 67 (interquartile range, 58-75) years, 40% had an ischemic cardiomyopathy, and median HF duration was 2.8 years (0.7-6.8). Median LVEF was 30% (23-35), and median change on follow-up was 4% (-2 to -13); 19% of patients had a decrease in LVEF, 31% had no change, 49% had a ≥5% increase, and 34% had a ≥10% increase. In a multivariable model, the following factors were associated with ≥5% LVEF increase: shorter HF duration (odds ratio [OR], 1.21 [95% CI, 1.17-1.25]), no implantable cardioverter defibrillator (OR, 1.46 [95% CI, 1.34-1.55]), lower LVEF (OR, 1.15 [95% CI, 1.10-1.19]), nonischemic cardiomyopathy (OR, 1.24 [95% CI, 1.09-1.36]), and no coronary disease (OR, 1.20 [95% CI, 1.03-1.35]). CONCLUSIONS: In a large cohort of outpatients with chronic HF with reduced EF, improvements in LVEF were common. Common baseline cardiac characteristics identified a population that was more likely to respond over time. These data may inform clinical decision making and should be the basis for future research on myocardial recovery.

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Published In

Circ Heart Fail

DOI

EISSN

1941-3297

Publication Date

July 2020

Volume

13

Issue

7

Start / End Page

e006833

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Stroke Volume
  • Registries
  • Recovery of Function
  • Prospective Studies
  • Middle Aged
  • Male
  • Humans
  • Heart Failure
  • Female
 

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DeVore, A. D., Hellkamp, A. S., Thomas, L., Albert, N. M., Butler, J., Patterson, J. H., … Fonarow, G. C. (2020). Improvement in Left Ventricular Ejection Fraction in Outpatients With Heart Failure With Reduced Ejection Fraction: Data From CHAMP-HF. Circ Heart Fail, 13(7), e006833. https://doi.org/10.1161/CIRCHEARTFAILURE.119.006833
DeVore, Adam D., Anne S. Hellkamp, Laine Thomas, Nancy M. Albert, Javed Butler, J Herbert Patterson, John A. Spertus, et al. “Improvement in Left Ventricular Ejection Fraction in Outpatients With Heart Failure With Reduced Ejection Fraction: Data From CHAMP-HF.Circ Heart Fail 13, no. 7 (July 2020): e006833. https://doi.org/10.1161/CIRCHEARTFAILURE.119.006833.
DeVore AD, Hellkamp AS, Thomas L, Albert NM, Butler J, Patterson JH, et al. Improvement in Left Ventricular Ejection Fraction in Outpatients With Heart Failure With Reduced Ejection Fraction: Data From CHAMP-HF. Circ Heart Fail. 2020 Jul;13(7):e006833.
DeVore, Adam D., et al. “Improvement in Left Ventricular Ejection Fraction in Outpatients With Heart Failure With Reduced Ejection Fraction: Data From CHAMP-HF.Circ Heart Fail, vol. 13, no. 7, July 2020, p. e006833. Pubmed, doi:10.1161/CIRCHEARTFAILURE.119.006833.
DeVore AD, Hellkamp AS, Thomas L, Albert NM, Butler J, Patterson JH, Spertus JA, Williams FB, Duffy CI, Hernandez AF, Fonarow GC. Improvement in Left Ventricular Ejection Fraction in Outpatients With Heart Failure With Reduced Ejection Fraction: Data From CHAMP-HF. Circ Heart Fail. 2020 Jul;13(7):e006833.

Published In

Circ Heart Fail

DOI

EISSN

1941-3297

Publication Date

July 2020

Volume

13

Issue

7

Start / End Page

e006833

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Stroke Volume
  • Registries
  • Recovery of Function
  • Prospective Studies
  • Middle Aged
  • Male
  • Humans
  • Heart Failure
  • Female